Kathryn Demos McDermott1, Samantha E Williams1,2, Mark A Espeland3, Kirk Erickson4, Rebecca Neiberg2, Thomas A Wadden5, R Nick Bryan5, Lisa Desiderio5, Regina L Leckie4,6, Lucy H Falconbridge5, John M Jakicic7, Miguel Alonso-Alonso8, Rena R Wing1. 1. Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island, USA. 2. Department of Psychology, Saint Louis University, St. Louis, Missouri, USA. 3. Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. 4. Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 5. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 6. Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA. 7. Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 8. Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
OBJECTIVE: The Action for Health in Diabetes (Look AHEAD) research study was a randomized trial comparing the effects of an intensive lifestyle intervention (ILI) versus a diabetes support and education (DSE) control group in adults with type 2 diabetes and overweight or obesity. Functional magnetic resonance imaging was used to determine whether neural food cue reactivity differed for these groups 10 years after randomization. METHODS: A total of 232 participants (ILI, n = 125, 72% female; DSE, n = 107, 64% female) were recruited at three of the Look AHEAD sites for functional magnetic resonance imaging. Neural response to high-calorie foods compared with nonfoods was assessed in DSE versus ILI. Exploratory correlations were conducted within ILI to identify regions in which activity was associated with degree of weight loss. RESULTS: Voxel-wise whole-brain comparisons revealed greater reward-processing activity in left caudate for DSE compared with ILI and greater activity in attention- and visual-processing regions for ILI than DSE (P < 0.05, family-wise error corrected). Exploratory analyses revealed that greater weight loss among ILI participants from baseline was associated with brain activation indicative of increased cognitive control and attention and visual processing in response to high-calorie food cues (P < 0.001, uncorrected). CONCLUSIONS: These findings suggest there may be legacy effects of participation in a behavioral weight loss intervention, with reduced reward-related activity and enhanced attention or visual processing in response to high-calorie foods.
RCT Entities:
OBJECTIVE: The Action for Health in Diabetes (Look AHEAD) research study was a randomized trial comparing the effects of an intensive lifestyle intervention (ILI) versus a diabetes support and education (DSE) control group in adults with type 2 diabetes and overweight or obesity. Functional magnetic resonance imaging was used to determine whether neural food cue reactivity differed for these groups 10 years after randomization. METHODS: A total of 232 participants (ILI, n = 125, 72% female; DSE, n = 107, 64% female) were recruited at three of the Look AHEAD sites for functional magnetic resonance imaging. Neural response to high-calorie foods compared with nonfoods was assessed in DSE versus ILI. Exploratory correlations were conducted within ILI to identify regions in which activity was associated with degree of weight loss. RESULTS: Voxel-wise whole-brain comparisons revealed greater reward-processing activity in left caudate for DSE compared with ILI and greater activity in attention- and visual-processing regions for ILI than DSE (P < 0.05, family-wise error corrected). Exploratory analyses revealed that greater weight loss among ILI participants from baseline was associated with brain activation indicative of increased cognitive control and attention and visual processing in response to high-calorie food cues (P < 0.001, uncorrected). CONCLUSIONS: These findings suggest there may be legacy effects of participation in a behavioral weight loss intervention, with reduced reward-related activity and enhanced attention or visual processing in response to high-calorie foods.
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